[Meta-analysis of clinical trials on family intervention in schizophrenia].
The present study aimed to assess the efficacy of cognitive-behavioral family interventions by relatives of schizophrenic patients under community care, specifically targeting relapse and family burden as outcomes. Independent researchers conducted the analyses of the pertinence and quality of trials identified through a search strategy, following a previously developed protocol. Eleven randomized or quasi-randomized trials were selected. The summary relative risk of relapse using the fixed effects model was favorable to family intervention, with estimated efficacy reaching nearly 60% (50%-70%). Summary relative risk in the cognitive-behavioral therapy trials subgroup [RR = 0.43 (0.28-0.67)] was equivalent to that of the behavioral therapy subgroup [RR = 0.37 (0.23-0.60)] and the "pragmatic" subgroup [RR = 0.37 (0.21-0.66)], although the "pragmatic" trials were generally analyzed for effective treatment. The difference in summary overall risk of relapse was nearly 30% using the random effects model. Only four trials analyzed family burden as outcome, including different dimensions of burden. Results of individual trials were generally favorable to family intervention, for both the objective and subjective dimensions.
Rodrigues
Maria Goretti Andrade
MG
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Krauss-Silva
Letícia
L
Martins
Ana Cristina Marques
AC
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D017281:Cost of Illness; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome